R.I.P. PHE

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

May 04, 2023 View in browser   By Daniel Payne Presented by With Robert King and Ben Leonard Driving the day Save the date: May 11 is the day the Covid-19 public health emergency ends. | Carolyn Kaster/AP Photo BACK TO THE FUTURE — The end of the Covid-19 public health emergency — and the return to some semblance of pre-pandemic health care — is one week away. The PHE began during the Trump administration and came to affect nearly all parts of American health care, Ben writes, with the government appropriating $4.6 trillion to fight the virus. Though some policies originally from the emergency declaration are here to stay, many patients, providers and health companies are preparing to readjust to the old ways of doing things. Key changes for Covid-related coverage ahead: — Much of the cost for treating Covid patients shifts to private insurers, which cover most Americans. — Uninsured Americans potentially face big bills should they become seriously sick, though the Biden administration has said access to vaccines and treatments with no out-of-pocket costs for the uninsured will continue through 2024. — Medicare, Medicaid and the Children’s Health Insurance Program beneficiaries could see more cost-sharing for tests and antivirals. Two other big changes, though not specifically linked to the end of the PHE, are happening at the same time: — The yearslong requirement for states to not remove people from Medicaid rolls recently ended, leaving millions at risk of losing coverage across the country. — The White House’s vaccine requirement for federal workers ends next Thursday. But not everything will change. Congress has continued some eased rules for telehealth in Medicare and high-deductible health plans, as well as hospital at-home waivers, through the end of 2024. And the pandemic’s dramatic changes for some health sectors are sure to have new momentum well beyond the end of the emergency that first spurred them on. WELCOME TO THURSDAY PULSE. Artificial intelligence has increasingly become a concern for the health world — including for medical schools, which are requiring applicants to certify their essays have been written with their intelligence alone. And it’s your intel alone that could be the key to the next big health story. Tell me what you know at dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ruth Reader interviews Carmen Paun, who discusses former NIH director Francis Collins' proposed plan to fund eight to 10 genomics centers in Africa for $130 million a year to help advance global pandemic preparedness, vaccine development and control of disease-transmitting insects and animals. Listen to today’s Pulse Check podcast   A message from PhRMA: Insurers and PBMs get savings that can reduce the cost of some brand medicines by 50% or more. But, they don’t have to share those savings with you. In fact, experts warn PBM incentives may lead them to prefer higher priced medicines. They collect exorbitant fees based off a medicine’s list price, which means they make more money when the price of a medicine goes up. It’s time to break the link between PBM fees and medicine prices.   At the Agencies Sen. Ron Wyden aims to fix the problem of Medicare Advantage's outdated directories of mental health providers. | J. Scott Applewhite/AP Photo GHOSTING GHOST NETWORKS — Sen. Ron Wyden (D-Ore.) is searching for a bipartisan way to clamp down on inaccurate mental health provider directories, also known as “ghost networks,” in Medicare Advantage, Robert reports. During a hearing in the Senate Finance Committee on Wednesday, Wyden said he hoped the panel could find a solution similar to legislation targeting Medicaid and the Children’s Health Insurance Program directories that passed in the omnibus spending bill last year. One potential solution is to standardize payer and provider requirements for updating directories, which can sometimes be out of date and inaccurate. Jack Resneck, the director of the American Medical Association, conceded at the hearing that doctors have a role to play, but “health plans are not making it easy for physicians to help.” Sen. Elizabeth Warren (D-Mass.) wants even stronger enforcement and warned plans may “lose the privilege” to offer narrow physician networks if they don’t fall in line.   A message from PhRMA:   In Congress FIRST IN PULSE: LAWMAKERS PUSH DEA ON BUPE — A bipartisan Senate group is calling for the Drug Enforcement Administration to do more to facilitate access to buprenorphine, a drug to treat opioid use disorder, Ben reports. “We are concerned that the DEA has failed to develop and provide sufficiently clear guidance for pharmacists, wholesalers, distributors, and patients for accessing buprenorphine,” Sens. Maggie Hassan (D-N.H.), Martin Heinrich (D-N.M.), Thom Tillis (R-N.C.), Elizabeth Warren (D-Mass.) and Sheldon Whitehouse (D-R.I.) said in a letter to the agency. The lawmakers called for the DEA to work with the FDA and the Substance Abuse and Mental Health Services Administration to end “access gaps.” Background: Congress enacted a law in December that ended a requirement that providers undergo time-consuming training to prescribe the drug, which helps patients wean themselves off opioids like fentanyl and heroin. But doctors across the country have told POLITICO they’ve had issues filling prescriptions as pharmacies and drug distributors try to avoid running afoul of the DEA system that tracks suspicious orders of controlled substances. The DEA previously told POLITICO that it’s working with pharmacies and making public statements to encourage prescribing and is looking to find bottlenecks in distribution. Speaking of a plan to encourage prescribing … POWER TO PRESCRIBE — The DEA will continue to allow doctors to prescribe controlled substances by telehealth — for now, Ben reports. The agency will keep the policy in place while it finalizes rules on prescribing now that the Covid public health emergency is ending, it said in a statement Wednesday. “The Drug Enforcement Administration received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully,” DEA Administrator Anne Milgram said in a statement. The agency’s announcement could signal it’s rethinking regulations it proposed in February that would have restricted telehealth access after the Biden administration ended the emergency on May 11.   GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGSITER HERE.     Public Health AN RSV SHOT FOR ADULTS — On Wednesday, the FDA approved the first vaccine against respiratory syncytial virus for adults 60 and older, POLITICO’s Katherine Ellen Foley reports. The vaccine, Arexvy, comes from GSK and was shown to be more than 80 percent effective in late-stage clinical trials. RSV produces mild, coldlike symptoms in most people, but older adults and young children are at a higher risk of developing severe disease. The CDC estimates the virus leads to between 60,000 and 160,000 hospitalizations annually among adults older than 65 in the U.S., and 6,000 to 13,000 deaths. For infants, those figures are between 58,000 and 80,000 hospitalizations annually and between 100 and 300 deaths. The FDA's approval is based on GSK following participants through an RSV season in an earlier Phase III study. The company will continue that trial for two more RSV seasons to study how long the shot’s protection lasts, the FDA said in a statement.   A message from PhRMA: Middlemen like PBMs are charging fees tied to the price of medicines, which means they make more money when the price of a medicine goes up. This business model allows PBM profits to soar and can lead to higher costs for patients. It’s time to break the link between PBM fees and medicine prices.   Names in the News Ochsner Health Plan has joined the Alliance of Community Health Plans. Jill Hamaker has left Emergent BioSolutions after more than a decade to join CGCN Group’s lobbying team as a partner. Hamaker joined the biotech firm, which manufactures the opioid overdose reversal drug Narcan, in 2010, and she most recently served as its head of federal government affairs. What We're Reading The Financial Times reports that a top WHO Covid investigator has been fired for sexual misconduct. Our Arek Sarkissian reports on the passage of a Florida bill banning Covid mandates. The Atlantic looks back at how overdoses have changed in the U.S.   DON’T MISS THE POLITICO ENERGY SUMMIT: A new world energy order is emerging and America’s place in it is at a critical juncture. Join POLITICO on Thursday, May 18 for our first-ever energy summit to explore how the U.S. is positioning itself in a complicated energy future. We’ll explore progress on infrastructure and climate funding dedicated to building a renewable energy economy, Biden’s environmental justice proposals, and so much more. REGISTER HERE.       Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops Ben Leonard @_BenLeonard_ David Lim @davidalim Krista Mahr @kristamahr Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Megan R. Wilson @misswilson   Follow us

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